There is a Seasonality to our Work

For me as a family physician, my seasonal work  includes, school and sports physicals in the summer, flu shots in the fall and winter and attention to problems associated with allergy in the spring. Similarly NHMS has seasonal priorities and now is our time to be active legislatively. We don't do this often but over the past few weeks we have asked you to speak out on an issue of importance to all of us. Thank you for taking time from your busy schedules to contact your legislators asking them to support the tobacco tax increase. Your calls will make a difference as the Senate and House negotiate the final budget.

Tommy, Can You Hear Me?

Spring is finally here, and Little League baseball players throughout the Granite State are oiling up their baseball gloves, taking swings in the batting cages and finally running around the infield.  Pitchers are staring intently at the catcher’s mitt, ready to strike out another Casey at the plate.  But a cautionary tale came our way from Major League Baseball last week from Miami via Tampa via Santa Clara, Cuba, about the limits of even the greatest young prospects.

Tragedy and Horror: Must Renew our Efforts to Prevent Violence.

Horrific events like last week's shootings shake us at our core, bring fear into our lives, and focus our thoughts on how precious and fleeting life truly is.  We ask ourselves why and seek answers so that we can prevent this from ever happening again. Unfortunately, these shootings are only the most recent in a string of violence and mass killings over the past 2 decades. The typical responses include that there are too many guns, or that there are too few guns, or that the mentally ill are dangerous, or that the mental health system is broken and severely underfunded.  Initially, there are calls for tighter gun control, looser gun control, and enhancing the mental health system. However, as we get further from each of these events, the energy and passion for prevention wanes, and we are then left with two highly polarized groups fighting over gun control sucking up all the airtime and energy for change.

Faster May Be Better

Last week a friend of the family suffered an ischemic stroke while talking to her children.  She developed difficulty speaking, had a right facial droop and right arm weakness.  She was taken to the local acute care hospital, had imaging studies to check for bleeding in the brain and, after a few days, was discharged home.  As I was told about her situation, a media story was released concerning recommendations about acute stroke management.  It related a series of articles from the Journal of the American Medical Association, discussing early management of stroke and the impact on decreasing disability.

Transparency Revisited - A Follow-up to My March 13th Note

Following my March 13th piece about Our Role in Price Transparency, I received a number of responses from our members that warrant sharing with you:


Family Physician to the Bereaved

As the unfortunate events unfolded in Ferguson, Missouri, over the past 10 days after a police officer shot and killed 18-year-old Michael Brown on August 9, much of the controversy centered on the lack of transparency of the investigation as to the events of the shooting.  The St. Louis County medical examiner had not released the results of the original autopsy as of August 17, which is the date when the Brown family’s privately hired forensic pathologist, Dr. Michael Baden, released details of his examination.  Dr. Baden was the former chief medical examiner for New York City and had examined the autopsy results of President John F. Kennedy and the Reverend Martin Luther King Jr.  Dr. Baden felt that his results showed that the unarmed Michael Brown was shot four times in the right arm and twice in the head.

Ezekiel's Run

In 1976, a futuristic cinema experience promised a life full of pleasure with just one catch — when you turned 30 years old, the life-clock crystal in your palm turned red, you were on your last day, and unless you wanted to head to the “Carrousel” for vaporization and “renewal,” you had to run.  While “Logan’s Run” may not have been the greatest sci-fi film ever made (“The Empire Strikes Back,” anyone?) it possibly is the reason that no one wants to admit they are a day over 29.  Recently, a new number has been thrust into the medical consciousness as another option for the last year of enjoyable life.  That number is 75, which has been proposed by Dr. Ezekiel Emanuel as his choice for leaving planet Earth for good or refusing further medical care.  See the article in The Atlantic.

Use Your Skills to Enrich the Debate

Science is facts; just as houses are made of stone, so is science made of facts; but a pile of stones is not a house, and a collection of facts is not necessarily science. Jules Henri Poincaré (1854-1912), French mathematician

Recently I was reminded that we often take our basic science skills for granted and how extremely valuable they truly are. Last week, on New Hampshire Public Radio's The Exchange, Tom Sherman, MD, a gastroenterologist and state representative from Rye, NH, spoke with clarity and reason to bring a scientific lens to the Medicaid expansion debate. (Listen to broadcast.)

Do No Harm

On the evening of April 29, 2014, inside the Oklahoma State Penitentiary in McAlester, Okla., convicted murderer Clayton D. Lockett was being put to death by lethal injection.  However, his vein that was allowing intravenous access collapsed before the full extent of the chemicals being used for the execution entered his body.  Eyewitnesses have reported that Mr. Lockett was still conscious 34 minutes after the execution began, and, at that point, the procedure was aborted.  Mr. Lockett eventually died of a heart attack one hour after the chemical infusion began.  There has been much discussion during the past week that Mr. Lockett, in effect, was tortured before dying.  See the NPR blog and CNN story.

Disability & Medical Care

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. 

-World Health Organization 1948